Organization Active NPI

Raber Medical PC

  • Internal Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1275756363
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
215962 Issued in NY
Legal business name
RABER MEDICAL PC
Practice address
3 School St
Suite 208
Glen Cove, NY 11542-2590
Phone
(516) 759-5011
Fax
(516) 676-1933
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eugene Raber, DONPI 1982766291
Title
Owner
Phone
(516) 759-5011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 215962 NY Primary

Addresses

Primary practice location

3 School St
Suite 208
Glen Cove, NY 11542-2590

Mailing address

3 School St
Suite 208
Glen Cove, NY 11542-2590
Phone (516) 759-5011

Other identifiers 1

IdentifierTypeStateIssuer
02077365MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070424000667 NY Part B Supplier - Clinic/Group Practice 8921103631 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Cove, NY

National Provider Directory

National Provider Directory

Locations

15 Glen St
Ste 101
Glen Cove, NY 11542
Phone (516) 759-5011

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1275756363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST",
            "address_2": "SUITE 208",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422590",
            "telephone_number": "516-759-5011",
            "fax_number": "516-676-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST",
            "address_2": "SUITE 208",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422590",
            "telephone_number": "516-759-5011",
            "fax_number": "516-676-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RABER MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "RABER",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-759-5011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "215962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02077365",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.